Therapeutic elements in a self-management approach: experiences from group participation among people suffering from chronic pain

Abstract

ObjectiveChronic pain is a complex, multifaceted subjective experience that involves the whole person. Self-management is the dynamic and continuous process of adapting one’s situation to the cognitive, behavioral, and emotional responses necessary to maintain a satisfactory quality of life. Approaches based on cognitive behavioral therapy (CBT) are described as appropriate in assisting people suffering from chronic pain because they challenge maladaptive beliefs and behaviors in relation to pain. This study aimed to explore patients’ experiences of therapeutic elements from group participation in a chronic pain management program.MethodsA qualitative research design with a phenomenological hermeneutic approach was used. Six months after participation in the 8-week course, 34 participants formulated and submitted written reports based on open-ended questions related to their group participation and self-help achievement. These reports were analyzed by elements of qualitative content analysis.ResultsThe analysis resulted in two subthemes: “The significance of active involvement in gaining new insight” and “The significance of community and group support.” These were abstracted in the main theme: “Successful self-management is related to several significant contributions in the group.”ConclusionAn active role with writing, self-revelation, and exchanges of thoughts and feelings in the group seemed to be the key tools for success. In addition, group support and access to other group members’ experiences were significant therapeutic elements. We suggest that successful self-management requires knowledge of essential therapeutic elements. In a CBT-based group approach, such elements may offer an important health care contribution.

Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners

“…Interestingly, a qualitative study of cognitive behavioral group treatment in CP patients showed that an active role with self-revelation and exchanges of thoughts and feelings in the group may be instrumental in achieving therapeutic success. 42 The exercise component in the Challenge is supported by an observational study in refractory CP patients, which found that a combination of behavioral therapy and exercise given to groups of individuals was followed by improvements in disability and pain intensity. 43 Finally, a recent systematic review of CP in youth showed that depression, anxiety, and pain intensity were associated with higher levels of disability, 38 and thus lends support to the supposed role of changes in depression, anxiety, and pain intensity in effectuating an improvement in HRQoL in our patients.…”

Experiences of Participants in a Self-Management Program for Employees with Complaints of the Arm, Neck or Shoulder (CANS): A Mixed Methods Study

“…Some people might need additional facilitation/support to use all the course materials to achieve the desired behavior. Therefore, it seems advisable to make a clearer referral to the more physically-orientated modules of the eHealth in the sessions or, for example, to include some physical aspects in each session, as was done in a self-management program for people with chronic pain [ 55 ]. Moreover, a computer-tailored eHealth module with content based on the participants’ characteristics, which leads participants through all the important topics, might be valuable.…”

Helsepedagogisk kompetanse, læring og mestring

“…Det totale antallet pasienter som er omtalt i studiene av pasientoppfatninger, er 398. Pasientene har type 2-diabetes (34), kroniske smerter (25,28), kreft (31), KOLS (29,33), irritabel tarmsyndrom (32) og hypertensjon (30). Det totale antallet fagpersoner som er omtalt i studiene om kompetanseoppfatninger, er 252.…”

“…De fleste studiene er kvalitative empiriske studier (22)(23)(24)(25)(26)(27)(28)(31)(32)(33)(34). Én studie er en systematisk oversikt over kvalitative studier (29) og tre har en mixed method-design (15,30,36).…”

“…De 16 inkluderte studiene belyser altså kompetanse fra ulike synsvinkler. Ikke alle problemstillingene i studiene hadde kompetanse som tema, men tok opp spørsmålet i presentasjonen av studienes resultater Hele tolv av de 16 studiene understreker at det er viktig å kunne lede grupper av pasienter og brukere for å tilrettelegge for laering og mestring på en adekvat måte (15,22,24,25,(27)(28)(29)(30)(31)(32)(33)(34)36). Studiene beskriver i hovedsak to dimensjoner ved gruppeledelse.…”